Acute work-related trauma remains a leading cause of death and disability among U.S. workers, and is very costly for workers'compensation systems and society as a whole. The overall goal of this project is to explore and document the Washington State Trauma Registry (WTR) as a previously underutilized source of data for work-related injury surveillance and occupational health services research. The primary hypothesis is that the WTR is useful for work-related injury research both as a stand-alone data source and as a source of data supplemental to the workers'compensation claims data maintained by the Washington State Department of Labor and Industries (L&I). The WTR contains pertinent information either not present in L&I claims data or present only for a subset of claims. This study will explore the untapped potential of the Washington State Trauma Registry (WTR) to serve as a source of surveillance data that could be used to improve case ascertainment for severe occupational traumatic injuries, identify populations at high risk, identify new or emerging injury patterns, improve occupational traumatic injury prevention programs, and contribute to assessments of under-reporting and differential workers'compensation claim filing by various subpopulations. This study involves linkage and secondary analysis of existing electronic administrative data from two state sources, the WTR and L&I workers'compensation claims. This study covers a span of 11 years, 1998 through 2008, to allow assessment of trends over time. Specific Aim 1: Describe work-related injuries captured by the WTR and explore and document the WTR as a resource for occupational injury surveillance/research. Specific Aim 2: Explore and document the feasibility and utility of linking WTR data to Washington State workers'compensation claims data to enhance state-based occupational injury research. Specific Aim 3: Explore and document the extent of under-representation of work-related traumatic injuries in L&I claims data and the potential of the WTR to contribute to case ascertainment. Evaluate whether there are trends in under-representation over time, overall and by severity and race/ethnicity. Specific Aim 4: Describe the distribution of payers and evaluate trends in payer coverage for work-related traumatic injuries captured by the WTR, overall and by severity and race/ethnicity. PUBLIC HEALTH RELEVANCE: Acute work-related trauma remains a leading cause of death and disability among U.S. workers, and is very costly for workers'compensation systems and society as a whole. This study will explore the untapped potential of the Washington State Trauma Registry to serve as a source of surveillance data that could be used to improve case ascertainment for severe occupational traumatic injuries, identify populations at high risk, identify new or emerging injury patterns, improve occupational traumatic injury prevention programs, and contribute to assessments of under-reporting and differential workers'compensation claim filing.